Article ; Online: Effect of Aggressive Intravenous Fluid Resuscitation Versus Nonaggressive Fluid Resuscitation in the Treatment of Acute Pancreatitis: A Systematic Review and Meta-Analysis.
2023 Volume 52, Issue 2, Page(s) e89–e100
Abstract: Objectives: Despite the need for active fluid therapy, fluid management of most acute pancreatitis (AP) cases is still supportive. The aim of this review is to compare the effect of aggressive versus nonaggressive intravenous (IV) fluid resuscitation in ...
Abstract | Objectives: Despite the need for active fluid therapy, fluid management of most acute pancreatitis (AP) cases is still supportive. The aim of this review is to compare the effect of aggressive versus nonaggressive intravenous (IV) fluid resuscitation in the treatment of acute pancreatitis. Methods: A systematic search of medical databases, such as Medline, Google Scholar, Science Direct, Cochrane Central, was conducted for publication until April 2022. We included randomized controlled trials or cohort (prospective and retrospective) studies reporting the outcomes of AP in patients that were managed with aggressive and nonaggressive IV fluid resuscitation. The primary outcome of interest was in-hospital mortality. Results: Fourteen trials involving 3423 acute pancreatitis patients were included in the review. We did not observe any differences in the risk of mortality, persistent organ failure, and systemic inflammatory response syndrome in both study groups. However, there was an increased risk of development of pancreatic necrosis, renal failure, and respiratory failure in the aggressive fluid therapy group compared with nonaggressive therapy. The funnel plot showed no publication bias. Conclusions: Aggressive fluid therapy did not improve mortality rates in acute AP patients and was associated with an increased risk of acute renal failure, and respiratory failure. |
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MeSH term(s) | Humans ; Pancreatitis/etiology ; Retrospective Studies ; Acute Disease ; Prospective Studies ; Fluid Therapy/adverse effects ; Acute Kidney Injury/etiology ; Respiratory Insufficiency/etiology |
Language | English |
Publishing date | 2023-05-25 |
Publishing country | United States |
Document type | Meta-Analysis ; Systematic Review ; Journal Article |
ZDB-ID | 632831-3 |
ISSN | 1536-4828 ; 0885-3177 |
ISSN (online) | 1536-4828 |
ISSN | 0885-3177 |
DOI | 10.1097/MPA.0000000000002230 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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